股后侧岛状皮瓣和肌皮瓣的临床应用

Clinical application of posterior gluteal island cutaneous and musculocutaneous flap

目的探讨应用股后侧岛状皮瓣修复大转子、骶部等处软组织缺损的临床效果。方法应用顺行股后侧岛状皮瓣修复大转子软组织缺损4例、骶部2例;逆行股后侧岛状皮瓣修复腘窝部皮肤缺损2例;肌皮瓣修复坐骨结节褥疮4例;供区直接缝合。结果除1例岛状皮瓣远端发生尖部坏死经植皮愈合外,余病例术后全部成活。随访1-5年,供区愈合良好、受区外形、质地及厚薄均较满意。结论该皮瓣以臀下动脉股后皮支及股深动脉穿动脉为其血供,解剖恒定,具有血运丰富、血管蒂长和切取容易等优点,适宜修复大转子、骶部坐骨结节及腘窝部等处软组织缺损。

Objective To investigate the application of posterior gluteal island cutaneous and musculocutaneous flaps for repairing soft tissue defects around greater trochanter and sacrum. Methods Antegrade posterior gluteal cutaneous island flaps were used for repairing soft tissue defects around greater trochanter in 4 cases and sacrum in 2 ; Retrograde flaps were used for popliteal soft tissue defects in 2; musculocutaneous flaps were used for ischial tuberosity bedsore in 4 cases. The donor defects were sutured. Results 1 case got distal flap tip necrosis, and healed after skin graft. All cases were followed up for 1 - 5 years. The donor sites healed well. The flaps got good configure, texture and thickness. Conclusions The posterior gluteal island flap is vascular supported by posterior cutaneous branch of inferior gluteal artery and deep femoral perforating arteries. The constant anatomy, rich blood supply, and a long vascular pedicle, are beneficial for harvest and repairing greater trochanter, ischial tuberosity and popliteal soft tissue defects.